05 June 2009

The devil is in the details. Health reform will fail unless we get serious cost control — and we won’t get that kind of control unless we fundamentally change the way the insurance industry, in particular, behaves. So let me offer Congress two pieces of advice:

1) Don’t trust the insurance industry.

2) Don’t trust the insurance industry.

Yeah, that point is worth repeating. And the whole article is worth a read.

10 comments:

I agree. I know someone very well who works fairly high up in a health care insurance company (as a physician) - and even he can't believe the crap that some of the more cut-throat capitlists in the company try and pull.

I'm waiting for the day that someone in the insurance industry get brought up on manslaughter charges for refusing to cover someone for life saving care that they are intitled to. You know that no one likes insurance folks when this dyed in the wool republican can't stand health insurance folks.

Insurance companies are not good at all; while I recognize that reality requires that they be included in any future healthcare picture, I'd prefer to see them heavily regulated. Screw profits....healthcare shouldn't be private; too much is at stake.

Whatever credibility the Nobel Prize committee had left after giving that POS Yasser Arafat the peace prize was lost when they gave Krugman the economics prize. The man is profoundly dishonest.

Krugman routinely writes things he knows aren't true, and his comments about the "public option" are no exception. Once one eliminates the straw men and red herrings from his column, there's nothing left.

Anyone with a modicum of literacy in economics (including Krugman) understands that the "public option" will have a built-in competitive advantage. Its purpose isn't to keep anyone "honest." Its purpose is to herd you lemmings to government coverage.

Anyone with a modicum of literacy in economics (including Krugman) understands that the "public option" will have a built-in competitive advantage.

Okay, I'll bite.

This "built-in competitive advantage" to which you refer is...what? This, From Harold Pollack at TNR?

"Compared with the fragmented array of private plans, the public sector can reduce costs. Government has superior bargaining power with drug companies, equipment suppliers, doctors, and hospitals. The public plan could act in concert with Medicare and Medicaid, and it would have greater leverage in encouraging standardized quality improvement strategies and electronic medical records. The public plan would thus establish quality and cost benchmarks the private sector would be hard-pressed to match."

And this is bad because the Poor Little Insurance companies can't possibly match this quality and low pricing without cutting into their bottom line? Aren't you actually making the case, as a conservative (I presume) *for* the public option here?

Also, you need to mention the other side of the equation--the competitive disadvantage the government currently shoulders as it pays, in full or in part, for the expensive care of disabled and chronically-ill (though in my eyes, all this only makes the argument for single payer that much stronger).

"Yet there is one additional argument that receives less attention. A public plan would provide an essential option--and an equally essential backup--for millions of Americans living with chronic illnesses or disabilities. Some of these Americans now receive Medicaid, with the accompanying inefficiencies, and indignities of meeting the requirements of a means-tested public assistance plan. Some receive private coverage--coverage that imposes burdensome deductibles, coverage gaps, and copayments, and that is often insecure. Still others endure even more precarious circumstances."

You would think we're treated like kings, right? That we have all the OPTIONS and CHOICES, that there is no RATIONING, and that we never experience any WAIT TIMES?

(I put those propaganda buzzwords in all caps, since that's what Big Insurance claims we're going to lose if we invite the dread Socialized Medicine or even it's weakling cousin, Reformed Healthcare, to come to America.)

Well, guess again. It still takes many months to get in to see a specialist, the boys' various non-formulary (but of course!) meds cost me several hundred out-of-pocket dollars per month, and health care is most certainly rationed, as we often put off (and put off, and put off) expensive things like dental work (no, not covered by our PPO--did I not mention that?) in order to pay bills.

So...let's say there is a public option, and it offers the same basics (a standard number of well-care visits for the boys, one mammogram per year for me, and X-dollars for catastrophic coverage), but there are wait times to see the participating doctors and elective surgery and dentistry is not covered. BUT, the premiums are considerably lower.

We are going to go with the public option, no question about it.

Its purpose is to herd you lemmings to government coverage.

Yeah, well, so what? There will still be private policies and private physicians, I believe, as there are in England and other countries with nationalized health care.

So those who enjoy the fact that their wealth can buy them something that no-one else gets to have can still feel good about themselves. Meanwhile, my mother-in-law, the widow of a decorated WWII veteran, will get the eye surgery she needs that we can't afford to pay for out-of-pocket right now.

The demand for healthcare in America currently exceeds the supply of health care.

The govt subsidizing health care will remove the remaining ties between the price of healthcare and the demand for healthcare.

Demand for healthcare will skyrocket.

The price of healthcare, by the immutable law of economics, shall likewise skyrocket.

Government being government, the quality of care will decrease. Fraud and incompetence will increase. Due the waste and the theft and increased demand the supply of resources to pay for healthcare will decrease, and so the quantity of healthcare will decrease.

Those who envision something superior to the current fascist (not capitalist) system as a result of govt action should research the govts medical care for the Indians and then ask if they would wish such a thing upon their least favorite person in the world. I know I wouldn't.

Krugman argues that the federal government should keep the insurance companies honest.

The govt...is gonna keep somebody honest? The govt? The American federal government? Enforcing honesty? Sure! I believe that one! And they are gonna help make sure costs go down? Uhuh. Sure. Got a bridge in New York you want to sell me Mr Krugman? Maybe there's some nice ocean front property in Arizona I could pick up for a bargain price?

litbrit - excellent post. It's shocking that millions of Americans lack healthcare access and also pay so much, and that there is no decent resource planning to meet people's needs. But I wouldn't waste time on Catron - he's a far right anti-society troll who also believes that there is no man-made climate change, that all the banks should have gone to the wall and Sarah Palin would be a world leader to rival Churchill or Abraham Lincoln. I kid you not.

I think it would be hard to argue that the current system works. However, the idea that our gov't can fix it is somewhat preposterous. Having worked as a primary care physician in both the Indian Health Services and the VA system, I can tell you the government does not belong anywhere near health care. We regularly have to refuse procedures, x-rays, meds to patients b/c they are not considered necessary by a beaurecrat in a completely different city. My patients regulary have to wait to see me (sometimes as long as 2mo), then have to wait again to see the specialists (who only work in the larger cities which is at least an hour away - even the cardiologists). There are never enough primary care physicians to care for the number of patients wanting to see us. Urgent care is not even offered in our community of 200,000. Patients have to drive over an hour to get to the VA urgent care center. Some have to drive closer to 3hours. It's just an incredibly inefficient, difficulty system to be working in, and it just keeps getting worse. Ask a vet.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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